Active NPI
Geoffroy I. Noonan, DO
- Psychiatry Physician
- Portland, ME
National Provider Identifier
1760644611
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- DO2238
- Practice address
- 66 Bramhall St
Portland, ME 04102-3344 - Phone
- (207) 662-1640
- NPI assigned
- Jul 1, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Psychiatry Physician | 2084P0800X | 52505 | MN | |
| Child & Adolescent Psychiatry Physician | 2084P0804X | DO2238 | ME | |
| Psychiatry Physician | 2084P0800X | DO2238 | ME | Primary |
Addresses
Primary practice location
66 Bramhall St
Portland, ME 04102-3344
Mailing address
66 Bramhall St
Portland, ME 04102-3344
Phone (207) 662-1640
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 52505 | MN | MD | Psychiatry Physician |
| DO2238 | ME | MD | Child & Adolescent Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1214870400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1468540800000",
"number": "1760644611",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "66 BRAMHALL ST",
"city": "PORTLAND",
"state": "ME",
"postal_code": "041023344",
"telephone_number": "207-662-1640"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "66 BRAMHALL ST",
"city": "PORTLAND",
"state": "ME",
"postal_code": "041023344",
"telephone_number": "207-662-1640"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NOONAN",
"first_name": "GEOFFROY",
"middle_name": "I.",
"name_prefix": "Dr.",
"credential": "DO",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-07-01",
"last_updated": "2016-07-15",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "MN",
"license": "52505",
"primary": false
},
{
"code": "2084P0804X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
"state": "ME",
"license": "DO2238",
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "ME",
"license": "DO2238",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Portland, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.